The Good News about Mammograms That No One Wants to Hear

Here's the bottom line, folks. The uproar over the "new" recommendation that women under 50 should not get regular mammograms is all about money not women's health.

In fact, since 1971 the science has been clear that women under 50 get no benefit from regular mammograms. That is, they die just as often from breast cancer as women who haven't gotten regular mammograms. But despite getting no benefit, all too many undergo unnecessary biopsies that leave scars both physical and mental.

That was the very clear message that just came from the expert panel that finally had the guts to tell the unvarnished truth to the public. You'd think this new clarification about the lack of benefits from an unnecessary test would be greeted with cheers.

Instead, it's been treated like an assault on women motivated by a dastardly effort--by those "death panel" advocates in the Obama Administration--to cut health care costs.

So rabid has the mammography industry become about protecting its profits that it has literally become "un-American" to tell the truth about mammography.

OK. You need proof. So let's talk.

First, why should you believe me? Because I've been writing about various aspects of women's health for 30 plus years, and I spent a year as an editor at MAMM, the women's magazine whose sole topic is women's cancers. I have a shelf-full of books about women's health including one that every woman should have: The Secret History of the War on Cancer, by Devra Lee Davis, the Director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute. (Look here for more about her.)

Second, even though someone is not a doctor, some facts about human breasts are easy for all of us to understand and go a long way to explaining the situation.

For instance, you might ask, what are they actually looking for on the X-ray film from a mammogram? Dr. Davis explains that they are looking for tiny white dots or other white shapes. This white "stuff," if you'll excuse the lack of scientific language, is calcium that can be left behind by cancerous cells as they grow. The breasts of women who have stopped menstruating and who are generally over 50, are fatty, and the fat shows up as black, a great background against which to see the white dots.

But the breasts of women under 50 are not fatty; they are dense, and are "riddled with lots of white spots, making it really hard to make out any tumor within," Davis writes in her book. So radiologists can only use their best guess to diagnose a particular white spot as suspicious, and most of the time--that's most of the time--they are wrong.

How wrong? In any given year, 70 of every 1,000 women under age 50 who have a mammogram will be told something suspicious has been found, meaning that over the decade between the age of 40 and 50, 700 women out of 1,000 will be told to undergo a biopsy.

Now a biopsy is no small thing. A friend of mine who underwent two of them--no cancer was found--described "excruciating pain." She was left with significant scars. And the mental anguish as women wait for the biopsy and then the result is similarly painful. Davis calls it "terror."

So if there's no benefit in terms of extending life, and all this downside of pain and anxiety--plus the expense--women under 50 should be cheering, not filled with new anxiety because of the recent announcement.

I find it shameful that most of the media coverage about the recommendations has sounded almost hysterical. You can just see the hand-wringing. The moaning about what women should do now? How will they cope? Etc. Etc.

Let's get over it, ladies. This is a step forward, not back. The advice is clear: if you're under 50, you will get no benefit from regular mammograms unless you are in a high-risk category. Over 50, you'll only have to get one every other year. That means less radiation, fewer trips to the imaging center, less humiliation as you have your boobs squished between two plates, fewer unnecessary biopsies, less mental anguish.

And is it a bad thing if we save some money besides?

Baby, Water Bottles Dangerous to Health

As I've been telling my friends ever since I wrote an article for Sierra Magazine on the subject, those attractive, hard-plastic water bottles that come in vivid, see-through colors, just aren't safe.

And that goes in spades for the baby bottles made from the same substance, polycarbonate plastic. You can usually identify bottles made of this plastic from the "#7 Other" recycling code on the bottom. One of the most popular manufactuers is Nalgene, but just yesterday, the company announced that it will stop production because of public concern.

The problem is a chemical called bisphenol-A, now recognized as a hormone disrupter that mimics estrogen. Ten years ago, as I reported in Sierra, a geneticist at Case Western University found that mice accidentally exposed to it from their plastic cages developed a high rate of chromosomal abnormalities.

Here's an excerpt from the just-released draft report on it from the National Toxicology Program (click on "draft report" in the right column to read it):

"The NTP concurs with the conclusion of the CERHR Expert Panel on Bisphenol A that there is some concern for neural and behavioral effects in fetuses, infants, and children at current human exposures. The NTP also has some concern for bisphenol A exposure in these populations based on effects in the prostate gland, mammary gland, and an earlier age for puberty in females." (italics from the report)

Bear in mind that this alarming report is coming from a most cautious federal agency. The list of possible other health effects is much longer. Scientists who've reviewed all the studies not funded by industry are very alarmed, and believe the chemical may be a cause of breast cancer. Something in our environment (my italics) is pumping up the breast cancer rate, as women have long suspected, and something is lowering the age of puberty for girls. The frustration has been not knowing which of the myriad chemicals to which we are exposed are causing these effects.

Here's the bottom line: this chemical may very well be particuarly dangerous for fetuses. Tell any pregnant women you know not to use these water bottles. And new parents should use other kinds of plastic baby bottles (soft or cloudy-colored plastic bottles don't contain it) or old-fashioned, but sanitary and safe, glass. Ditto for sippy cups or dishes.

The bad news, however, is that while we can choose to avoid those products, babies drinking infant formula will still be exposed to it. Most canned food sold in America is coate with the stuff. Last year, the Environmental Working Group found it in 55 of 97 cans they tested. And, even worse, they found the highest levels of the chemical in infant formula, at levels that had caused serious adverse harm to animals.

And by the way, don't be persuaded by industry people saying animal studies don't prove anything about how something will affect people. They use animal studies all the time to prove the safety of drugs they want to sell before they test them in people.

It may be years before the U.S. Food & Drug Administration acts to stop use of this chemical, but other countries, as usual these days, are already acting. The New York Times reported Wednesday that Canada is apparently close to declaring it a toxic chemical. And Wal-Mart Canada just announced it will stop selling products containing it.

As I've said before on this blog, we should stop walking for the cure but for real prevention. (Early detection is not prevention, despite the bill of goods sold to so many cancer survivors.) Bisphenol-A may cause cancer as well as birth defects and harm to reproductive organs. It's not filling some essential need. So why should we be exposed to it ?